Organization
SURGICAL BARIATRICS NORTHWEST, INC. P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN L. PENNINGS MD (PRESIDENT)
(208) 262-0945
Entity
Organization
Contact information
Practice address
750 N SYRINGA ST, SUITE 205, POST FALLS, ID 83854-5275
(208) 262-0945
(208) 415-0150
Mailing address
750 N SYRINGA ST, SUITE 205, POST FALLS, ID 83854-5275
(208) 262-0945
(208) 415-0150
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/03/2006
Last updated
07/18/2007
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